A Decision-Making Aid for Long-Term Care Waiting List Policies: Modelling First-Come, First-Served vs. Needs-Based Criteria

Burkell, Jacquelyn; Wright, Alison; Hoffmaster, Barry; Webb, Kathleen

doi:10.1016/s0840-4704(10)60942-8

Cited by 11 publications

(7 citation statements)

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“…The articles included were published between 1989 and 2019. Most of the studies were conducted in Canada [ 22 , 23 , 25 , 26 , 30 – 33 , 40 , 42 , 48 , 50 , 53 , 57 , 59 , 61 , 67 ], Spain [ 21 , 28 , 29 , 37 , 38 , 41 , 52 , 54 – 56 , 60 , 62 ], and New Zealand [ 27 , 34 – 36 , 49 , 58 , 63 ]. As presented in Table 1 , these studies’ stated goals were mainly related to evaluating validity and reliability, developing prioritization criteria, and creating prioritization tools.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of patient prioritization tools in non-emergency healthcare services

et al. 2020

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Background Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings. Methods We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently. Results We included 48 studies listing 34 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two-thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients. Conclusions This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings. Systematic review registration PROSPERO CRD42018107205

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Section: Resultsmentioning

confidence: 99%

A systematic review of patient prioritization tools in non-emergency healthcare services

et al. 2020

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“…12 Both those studies are about altering the priority setting from first-come-first-served to a needs-based criterion, so no mathematical model was involved. 16,17 In the light of that background, the allocation model based on preference profiles is a new concept in the geriatrics domain.…”

Section: Discussionmentioning

confidence: 99%

Reduced Waiting Times by Preference-Based Allocation of Patients to Nursing Homes

Arntzen¹,

Bekker²,

Smeekes³

et al. 2022

Journal of the American Medical Directors Association

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“…The gap between needs and services provision may be too great to be resolved, but models assessing the impact of changes on the amount of resources used or the impact of health policies on the management of need and demand are useful in decision making [29]. Several studies have taken advantage of simulation to assess needs for health services [5,7,20]. Jüni et al [15] used a crosssectional population-based sample to estimate the requirement for knee arthroplasty but made no forward projection of the population need for knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Unmet Needs and Waiting List Prioritization for Knee Arthroplasty

Comas¹,

Román²,

Quintana

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background There is a high volume of unmet needs for knee arthroplasty in the population despite the increase in surgery rates. Given the long waiting times to have a knee arthroplasty, some governments have proposed prioritization systems for patients on waiting lists based on their level of need. Questions/Purposes We therefore estimated the needs and demand of knee arthroplasty in four regions of Spain during a 5-year period. Methods We developed a discrete event simulation model to reproduce the process of knee arthroplasty. The prioritization system was compared with the usual waiting list management strategy (by waiting time only).Results Under the prioritization system, patients saved an average of 4.5 months (95% confidence interval, 4.4-4.6 months) adjusted by level of need. The proportion of patients who experienced excessive waiting times was small and was associated with low levels of priority. The 5-year projection of the volume of unmet needs for knee arthroplasty remained stable; however, although the volume of need for the first knee arthroplasty decreased by 12%, the volume of need for an arthroplasty in the contralateral knee increased by 50%. Conclusions The data suggested the prioritization system was more beneficial than assigning surgery by waiting time only. The 5-year projection of the volume of unmet needs for knee arthroplasty remained stable, despite the increase in the need for contralateral knee arthroplasty. Level of Evidence Level II, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.

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A Decision-Making Aid for Long-Term Care Waiting List Policies: Modelling First-Come, First-Served vs. Needs-Based Criteria

Cited by 11 publications

References 0 publications

A systematic review of patient prioritization tools in non-emergency healthcare services

A systematic review of patient prioritization tools in non-emergency healthcare services

Reduced Waiting Times by Preference-Based Allocation of Patients to Nursing Homes

Unmet Needs and Waiting List Prioritization for Knee Arthroplasty

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